Objective : To investigate the expression of LncRNA PXN-AS1(abbreviated as PXN-AS1) in gastric cancer tissues and its impact on the proliferation, apoptosis, and invasion of gastric cancer cells, and to explore its potential regulatory mechanisms. Methods : Gastric cancer tissues and adjacent tissues from 43 patients with gastric cancer were collected. The expression levels of PXN-AS1 and miR-125a-5p in gastric cancer tissues were detected using qRT-PCR, and the relationship between the expression level of PXN-AS1 and the clinical pathological parameters of patients with gastric cancer was analyzed. Pearson correlation analysis was conducted to evaluate the correlation between PXN-AS1 and miR-125a-5p in gastric cancer tissues. PXN-AS1 siRNA plasmid(si-PXN-AS1) and negative control plasmid(si-NC), as well as miR-125a-5p inhibitor(inhibitor) and negative control miRNA inhibitor(inhibitor NC), were transfected alone or in combination into HGC-27 cells. The cells were divided into si-NC group, si-PXN-AS1 group, si-PXN-AS1+inhibitor NC group, si-PXN-AS1+inhibitor group, and a blank control group was also established. qRT-PCR was utilized to assess the expression levels of PXN-AS1 and miR-125a-5p in each cell group. CCK-8 assay was employed to evaluate the proliferation levels of cells in each group. EdU experiment was conducted to assess the proliferation status of cells in each group. Transwell assay was performed to examine the migration and invasion capabilities of cells in each group; flow cytometry was employed to measure the apoptosis levels of cells in each group; the dual-luciferase reporter gene system was used to validate the sponge absorption of PXN-AS1 on miR-125a-5p and regulate its expression levels. Bioinformatics analysis was employed to screen downstream target genes of miR-125a-5p and perform GO and KEGG enrichment analysis. Results : Compared with adjacent cancerous tissues, the expression level of the PXN-AS1 in gastric cancer tissues significantly increased, while the expression level of miR-125a-5p markedly decreased(bothP<0.05). PXN-AS1 and miR-125a-5p exhibited a negative correlation(r=-0.452,P=0.002). Furthermore, gastric cancer patients with high expression of PXN-AS1 exhibited the proportions of lymph node metastasis positivity and low differentiation were significantly higher(allP<0.05). Compared to the blank group and si-NC group, the si-PXN-AS1 group of HGC-27 cells showed significantly reduced levels of PXN-AS1 expression, cell proliferation capacity, and the number of cell migration and invasion(allP<0.05), while the level of cell apoptosis significantly increased(P<0.05). The dual-luciferase reporter system results demonstrated specific adsorption of miR-125a-5p by PXN-AS1 in HGC-27 cells. Knockdown of miR-125a-5p could reverse the effect of PXN-AS1 silencing on the inhibition of proliferation, migration and invasion of gastric cancer cells, and promote apoptosis. The bioinformatics analysis results indicated that the downstream target genes of miR-125a-5p were involved in various biological processes, including DNA damage, T cell apoptosis and differentiation, RNA metabolism synthesis processes, and signal transduction. Additionally, miR-125a-5p was implicated in signaling pathways such as the HIF-1 pathway, JAK-STAT pathway, and cell apoptosis signaling pathway. Conclusion PXN-AS1 is upregulated in gastric cancer. Moreover, acting as a competitive sponge for miR-125a-5p, PXN-AS1 promotes the proliferation, migration, and invasion abilities of gastric cancer cells HGC-27 while inhibiting apoptosis.

Objective:To investigate the gait characteristics of patients with early Parkinson′s disease (PD) under cognitive dual task, and to provide sensitive kinematic indicators for the early diagnosis, timely treatment and reasonable rehabilitation of PD.Methods:A total of 62 outpatients and inpatients with early non-tremor Parkinson′s disease in Shijingshan Branch of Beijing Chaoyang Hospital Affiliated to Capital Medical University from September 2021 to August 2023 were selected as experimental group (PD group), and 62 healthy controls with comparable age composition ratio were selected as control group. The baseline data, Montreal Cognitive Assessment Scale scores, and the gait assessment scores of the motor part of the Unified Parkinson′s Disease Rating Scale were compared between the 2 groups. The wearable gait analysis device was used to collect the gait parameters of the 2 groups of subjects under single task and dual task, and the foot kinematic characteristics of the patients with early PD were quantified. Independent sample t test and Mann-Whitney U test were used to analyze the gait parameters of the 2 groups. The statistically significant variables were included in Logistic regression analysis to explore the association between gait parameters and PD. Finally, the diagnostic value of the variables was estimated by receiver operating characteristic (ROC) curve analysis. Results:Gait spatio-temporal parameters (per gait cycle): (1) The gait speed of the PD group was slower than that of the control group [(1.01±0.12) m/s vs (1.22±0.18) m/s, t=-7.526] during single task walking. The bipedal support time in the PD group was significantly longer than that in the control group [(0.29±0.05) s vs (0.22±0.06) s, t=6.659]. The differences were both statistically significant (both P<0.001). (2) During dual-task walking, PD patients showed slower gait speed [(0.88±0.11) m/s vs (1.19±0.16) m/s, t=-12.158, P<0.001]. The bipedal support time in the PD group was longer than that in the control group [(0.36±0.05) s vs (0.22±0.05) s, t=12.828, P<0.001]. PD patients had shorter stride length [(109.20±6.21) cm vs (112.77±5.87) cm, t=-3.203, P=0.010]. Stride frequency in the PD group was higher than that in the control group [(114.45±7.10) steps/min vs (110.87±7.16) steps/min, t=2.724, P=0.020]. The single leg support time was longer than that of the control group [(0.49±0.12) s vs (0.45±0.06) s, t=2.643, P=0.020] , and the differences were statistically significant. Gait kinematics parameters: (1) During single task walking, the maximum angle of foot movement in the sagittal plane in the PD group was smaller than that in the control group (17.19°±2.37° vs 19.71°±2.92°, t=-4.691, P<0.001). The minimum angle of movement in the sagittal plane was smaller than that in the control group (-67.08°±4.63° vs -70.10°±3.94°, t=0.395, P=0.001). The minimum horizontal angle of the foot during exercise in the PD group was lower than that in the control group (9.08°±4.02° vs 11.80°±3.60°, t=-3.461, P<0.001). The minimum angle of the foot coronal plane in the PD group was smaller than that in the control group (-10.55°±2.87° vs -12.04°±2.31°, t=2.831, P=0.030; the negative sign only represents the movement direction). The touch angle of the foot in the PD group was significantly lower than that in the control group (11.14°±2.78° vs 12.78°±3.57°, t=-2.779, P=0.030). (2) During dual-task walking, the maximum sagittal angle (15.44°±2.54° vs 18.99°±2.71°, t=-6.673, P<0.05), the minimum angle of sagittal plane (-65.68°±4.73° vs -70.02°±4.04°, t=-4.747, P<0.001; the negative sign only represents the direction of movement), the minimum coronal movement angle (-11.15°± 2.99° vs -13.18°±2.50°, t=3.642, P=0.020), the touch angle (11.01°±3.10° vs 12.83°±4.01°, t=-2.438, P=0.010), the minimum horizontal angle (8.83°±4.04° vs 11.83°±3.63°, t=-3.776, P<0.001), and the change of the angle from the ground (-65.00°±3.54° vs -67.06°±3.61°, t=3.133, P<0.001) in the PD group were all smaller than that in the control group. The differences were all statistically significant. Logistic regression analysis showed that step frequency was positively correlated with PD ( OR=1.124,95% CI 1.040-1.201, P=0.001), minimum angle of coronal plane was positively correlated with PD ( OR=1.501, 95% CI 1.040-2.151, P=0.030). Stride length was negatively correlated with PD ( OR=0.902, 95% CI 0.830-0.978, P=0.010). ROC curve was used to evaluate the diagnostic value of step frequency, stride length and minimum angle of coronal plane. For step frequency, when the maximum Youden index was 0.880, the best cut-off value to distinguish the PD group from the control group was 115.000, the sensitivity was 0.577, the specificity was 0.710, and the area under the curve was 0.656. For the minimum coronal angle, when the maximum Youden index was 0.251, the best cut-off value was -12.575, the sensitivity was 0.728, the specificity was 0.531, and the area under the curve was 0.670. For stride length, when the maximum Youden index was 0, the best cut-off value was 100.91, the sensitivity was 0.950, the specificity was 0.050, and the area under the curve was 0.300. Conclusions:Some gait parameters such as step frequency and minimum angle of coronal plane can be used as kinematic markers to reflect the gait characteristics of early PD, which may be helpful in tracking and evaluating the gait disorder characteristics of early PD patients and predicting the risk of PD. Some gait parameters of PD patients are significantly different from those of healthy people during cognitive-motor dual-task walking.

New drug discovery is under growing pressure to satisfy the demand from a wide range of domains, especially from the pharmaceutical industry and healthcare services. Assessment of drug efficacy and safety prior to human clinical trials is a crucial part of drug development, which deserves greater emphasis to reduce the cost and time in drug discovery. Recent advances in microfabrication and tissue engineering have given rise to organ-on-a-chip, an in vitro model capable of recapitulating human organ functions in vivo and providing insight into disease pathophysiology, which offers a potential alternative to animal models for more efficient pre-clinical screening of drug candidates. In this review, we first give a snapshot of general considerations for organ-on-a-chip device design. Then, we comprehensively review the recent advances in organ-on-a-chip for drug screening. Finally, we summarize some key challenges of the progress in this field and discuss future prospects of organ-on-a-chip development. Overall, this review highlights the new avenue that organ-on-a-chip opens for drug development, therapeutic innovation, and precision medicine.

Objective:To evaluate the efficacy and safety of peroral endoscopic myotomy (POEM) in achalasia of cardia (AC) patients with the long course.Methods:A total of 159 AC patients who received POEM from January 2015 to March 2022 in the First Affiliated Hospital of Soochow University were divided into the long course group (≥10 years) and the non-long course group (<10 years). The baseline information, POEM procedure and postoperative recurrence were compared and the differences between the recurrent patients and non-recurrent patients in the long course group were explored.Results:The age (57.09±14.30 years VS 42.08±15.68 years, t=5.569, P<0.001), the rate of treatment history [28.9% (13/45) VS 9.6% (11/114), χ2=9.319, P=0.020], the proportion of Henderson grade Ⅲ esophagus [17.8% (8/45) VS 6.1% (7/114), χ2=7.020, P=0.030] in the long course group were significantly higher than those in the non-long course group. The recurrence rate in the long course group was significantly higher than that in the non-long course group [33.3% (15/45) VS 14.9% (17/114), χ2=6.811, P=0.009]. In the long course group, the age (62.50 ± 16.94 years VS 53.77 ± 12.95 years, t=-2.121, P=0.040), and the rate of treatment history [53.3% (8/15) VS 16.7% (5/30), χ2=6.544, P=0.016] in the recurrent patients were higher than those in the non-recurrent patients. Conclusion:POEM is safe and effective for long-course AC patients. In patients with the long course, the aged patients with previous treatment are more likely to relapse.

Objective:To study the efficacy and safety of EndoClot polysaccharide hemostatic system (EndoClot PHS) for heparinized arterial hemorrhage of upper digestive tract (Forrest Ⅰa) in animal model.Methods:Twelve experimental pigs were randomly divided into the test group ( n=6) and the control group ( n=6) by simple random grouping method. Gastric arterial hemorrhage models were established. Endoclot PHS and Hemospray were used to spray on the wound to stop bleeding in the test group and the control group respectively. The time of effective hemostasis, the amount of hemostatic particles used, and the blockage of the powder feeding tube and its replacement were compared between the two groups. The survival and complications of experimental pigs were observed after the operation. In 10 days after the operation, the experimental pigs were euthanized for pathological dissection. Results:Spurting or pulsatile bleeding was achieved in all experimental pigs. There were significant differences in the time of effective hemostasis (8.75±0.84 min VS 9.83±0.62 min, t=-2.53, P=0.030) and the amount of hemostatic particles used to achieve effective hemostasis (6.71±0.39 g VS 14.10±1.62 g, t=-10.86, P<0.001) between the test group and the control group. There was no significant difference in the occurence of clogging or the replacement of powder feeding pipes between the two groups (0.64±0.02 times VS 0.67±0.04 times, t=-1.64, P=0.131). In addition, the gas source of the test group was stable, and the visual field under the endoscope was clear. Neither the test group nor the control group had gastric lesions, perforation, or embolism. The blood glucose, blood routine, and liver and kidney functions were normal, and no thrombosis or embolism of the main organs occurred in either group. Conclusion:EndoClot PHS is safe and effective for heparinized upper gastrointestinal arterial hemorrhage (Forrest Ⅰa) in animal models.

Objective:To evaluate the efficacy of hemostatic powder on preventing delayed bleeding after endoscopic submucosal dissection (ESD).Methods:Patients who received ESD in the First Affiliated Hospital of Soochow University and Yulin No.2 Hospital from June 2017 to August 2018 were enrolled with informed consents, and randomly divided into the study group and the control group. Hemostatic powder was applied on post-ESD ulcer after routine hemostasis method in the study group, and the control group was given routine hemostasis method only. The time and dosage of hemostatic powder spraying and its adverse events were observed in the study group. The operation time, rate of delayed bleeding (within 30 days after operation) and early delayed bleeding (within 48 hours after operation), and postoperative hospital stay were compared between the two groups.Results:A total of 196 patients were enrolled including 97 in the study group and 99 in the control group. The baseline data were comparable between the two groups (all P>0.05). In the study group, the time to spray powder was 68.78±19.75 s, dosage was 2.51±0.93 g. Powder delivery catheter was blocked in one case (1.03%, 1/97). No adverse event was reported during 30 days of follow-up. The operation time was not statistically different in the study group and the control group (61.92±11.71 min VS 59.76±11.01 min, t=1.330, P=0.185). The delayed bleeding rate of the study group was significantly lower than that of the control group [1.03% (1/97) VS 8.08% (8/99), P=0.035]. There was no case of early delayed bleeding occurred in the study group, while 6 cases (6.06%, 6/99) in the control group ( P=0.029). The postoperative hospital stay was not statistically different between the study group and the control group (4.57±0.85 d VS 4.86±1.37 d, t=1.778, P=0.077). Conclusion:Although capacity of hemostatic system remains to be improved, hemostatic powder is an effective, safe and simple method to reduce delayed bleeding rate after ESD, especially on early delayed bleeding.

Objective:To study the clinical characteristics and classification of gastric neuroendocrine neoplasm(NEN) and prognostic factors of mixed adenoneuroendocrine carcinoma (MANEC) and gastric neuroendocrine carcinoma(NEC).Methods:A total of 148 gastric NENs were divided into type Ⅰ, type Ⅱ and type Ⅲ based on the classification of European Neuroendocrine Tumor Society (ENETS). Kaplan-Meier test and Cox regression model were used in univariate and multivariate survival analysis in 108 cases with pathological G3 gastric NEN.Results:In this study, the percentages of type Ⅰ, type Ⅱ and type Ⅲ were 25.0%(37), 3.4%(5) and 71.6%(106) respectively. Among type Ⅰ patients, 28(75.7%) lesions were located in gastric fundus or body, 29(78.4%) had bumps. Lymph node involvement was found in 4 (10.8%) patients. Twenty-six (70.3%) patients received endoscopic treatment and 11 (29.7%) with surgery. All 5 type Ⅱ patients presented lesions in gastric fundus or body, including 4 with ulcers, who were all treated by endoscope. Three type Ⅱ patients had gastrinoma, and 2 combined with multiple endocrine neoplasmⅠ. In type Ⅲ patients, 56(52.8%) showed ulcerative lesions. The majority of patients (102, 96.2%) had a single lesion, 94(88.7%) with lymph node or other organ metastasis. In this study, no deaths were reported in gastric NEN with a pathological grade of G1 or G2. The mortality rate was 38.9%(42/108) in patients with G3 NEN. Survival analysis suggested that age, metastasis of tumor were associated with poor prognosis ( P=0.041, 0.025). Conclusions:Patients with gastric NEN have heterogenous clinical presentations according to gender, age, endoscopic features, infiltration and metastasis, and pathological grade. Aging and metastasis are negative prognostic factors of G3 gastric NEN.

Objective To investigate the application value of diffusion kurtosis imaging (DKI) in the changes of prefrontal cortex microstructures in patients with mild cognitive impairment (MCI). Methods A total of 79 consecutive patients with cerebral small vascular disease admitted to the Department of Neurology, Chaoyang Hospital, Capital Medical University between January 2018 and December 2018 were enrolled retrospectively. They were confirmed by head MRI and MR angiography and Montreal cognitive assessment scale (MoCA) was used to assess the overall cognitive function. According to the presence or absence of MCI,79 patients were divided into MCI group (n = 46) and non-MCI group (rc = 33). The general clinical data of the two groups of patients were recorded and analyzed; neuropsychological assessment results, including MoCA scale, Hamilton depression rating scale (HAMD) , Hamilton anxiety rating scale (HAMA); conventional MR morphology, and DKI scan results. The prefrontal cortex of the patients was selected as the region of interest, i. e. , bilateral dorsolateral superior gyrus, medial superior frontal gyrus,anterior cingulate,and paracingulate gyrus; the DKI related parameters of the region of interest were measured, including mean diffusivity (MD) , fractional anisotropy (FA), axial kurtosis (AK),mean kurtosis (MK) ,and radial kurtosis (RK). The Bonferroni method was used to adjust P values for multiple comparisons of multiple regions of interest The P value was adjusted with P < 0. 008 (0. 05/6 = 0. 0083) as the difference was statistically significant. Results (1) The MoCA scale score in the MCI group was lower than that in the non-MQ group. There was significant difference between the two groups (20 [19,22] vs. 27 [25,28] ,Z = -6. 836,P<0. 01). There were no significant differences in age,gender,years of education,HAMD score,and HAMA score between the two groups (all P>0.05). (2) In the right anterior cingulate and paracingulate gyrus,the FA,AK and MK values of the MCI group were lower than those of the non-MCI group. The differences were statistically significant between groups (0. 16 ±0.03 us. 0. 18 ±0.03, 0. 64 ± 0.08 vs. 0.70 ± 0.06, and 0. 67 ± 0. 09 vs. 0. 73 ± 0. 06, all P < 0. 008). There were no significant differences in MD and RK values between the two groups (all P >0. 008). In the left anterior cingulate and paracingulate gyrus,there were no significant differences in MD,FA, AK,MK and RK between the two groups (all P>0.008). (3) There were no significant differences in the MD,FA,AK,MK and RK values between the bilateral dorsolateral superior frontal gyrus and bilateral medial superior frontal gyrus (all P > 0. 008). Conclusions DKI technique can be used to observe the microstructural change of prefrontal cortex matter in patients with MCI. The parameters related to DKI have certain value in clinical imaging evaluation of patients with MCI.

Objective To evaluate the clinical value of endoscopic submucosal tunnel dissection ( ESTD) for treatment of large gastric angle superficial neoplasms. Methods A retrospective analysis was performed on data of 87 patients with superfical neoplasms in gastric angle, including 32 cases undergoing ESTD and 55 cases undergoing endoscopic submucosal dissection ( ESD) in 6 institutions between July 2014 and July 2016. The dissection time, dissection speed, en bloc resection rate, curative resection rate, adverse events, and prognosis were compared between the two groups. Results The ESTD group showed a shorter dissection time ( 87. 3 ± 32. 6 min VS 136. 7 ± 64. 5 min, P<0. 01 ) , a higher dissection speed ( 0. 18 ± 0. 07 cm2/min VS 0. 08±0. 05 cm2/min, P<0. 01), a higher en bloc resection rate[100％ (32/32) VS 87. 3％ (48/55), P=0. 035], and a higher curative resection rate[100％ (32/32) VS 85. 5％ (47/55), P=0. 024] compared with the ESD group. The intraoperative bleeding rate[59. 4％ (19/32) VS 100. 0％( 55/55) , P<0. 01] and muscular injury rate[ 0 ( 0/32) VS 14. 5％ ( 8/55) , P=0. 024] were lower in the ESTD group than those of the ESD group. There was no statistical difference on recurrence rate between the two groups[0 (0/32) VS 1. 9％ (1/54), P=0. 443]. Conclusion ESTD has a higher dissection speed and greater security on treatment of large gastric angle superficial neoplasms, and is worthy to be generalized.

To establish a quantitative estimate model for diagnosing traditional Chinese medicine (TCM) syndromes of patients with osteoporosis.